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Document Type

DNP - University Access Only

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing


PHQ-9, nurse-driven protocol, emergency department, behavioral health


Background/Purpose: There is a significant lack of research evaluating the effectiveness of a nurse-driven triage protocol for the management of behavioral health (BH) patients in critical access emergency departments (EDs). The purpose of this project was to better triage and manage BH patients in the rural ED. Methods: The project sample included patients aged 13 years old and above presenting to the ED with a BH complaint. Patients were triaged using the nurse-driven triage protocol that included the Patient Health Questionnaire (PHQ-9) and a standardized laboratory order set. The amount of time each patient spent in the ED was tracked over the course of 90 days and subsequently compared to ED visit times from 1 year prior to the implementation of the nurse-driven triage protocol. Results: The difference in the mean length of stay (LOS) time post-implementation and pre-implementation was not statistically significant. Discussion: Despite the lack of statistical significance, the nurse-driven triage protocol was utilized appropriately by ED staff members with positive feedback.
Implications for Practice: The utilization of nurse-driven triage protocols for patients presenting to the ED has demonstrated better patient outcomes and improved nurse satisfaction. The organization felt the triage protocol could prove beneficial to future policy development.

Library of Congress Subject Headings

Patients -- Mental health -- Treatment.
Evidence-based nursing.
Rural health services.
Nursing care plans.
Medical protocols.

Number of Pages



South Dakota State University


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